The new national Patient Protection and Affordable Care Act (ACA), often called Obamacare, will affect Massachusetts residents very little, according to Sarah Kuh, director of Vineyard Health Care Access (VHCA), a group funded by Island towns to assist people searching for affordable, quality health insurance.
“If you have insurance now, little will change,” Ms. Kuh said. “If you don’t have insurance, you may have more options than you had before.”
Massachusetts health care law changes in 2006 have led to about 97 percent of all state residents being covered by an insurance plan.
The federal plan that went into effect on October 1 is modeled in part after the 2006 state program, called Commonwealth Care. The Massachusetts plan has helped the state reach almost universal medical insurance coverage, according to the Mass.gov health and human resources website.
The most significant change here will be for people with coverage through Commonwealth Care who will have to re-enroll in one of plans offered through the new federal exchange. The new federal program is run by the Health Connector in Massachusetts.
The national open enrollment period is October 1, 2013 through March 31, 2014. Health coverage will begin on January 1, 2014, for people who enroll or re-enroll between October 1 and December 15, 2013.
Ms. Kuh said there may be more benefits and even reductions in cost through the new federal program, which offers subsidies for some qualifying applicants. Some reductions will come in the form of reduced premiums and tax credits. There may even be premium assistance subsidies for students and people with employer provided insurance. Commonwealth Care does not offer similar benefits.
“I am recommending that everybody try out the new exchange to find out what they qualify for,” she said. “If you have trouble getting through, try again, and there is a state phone number providing around the clock help, 1-800-841-2900.”
Under the new ACA rules, Medicaid, the federally sponsored and state-run program for low-income people and those with some illnesses, called MassHealth in Massachusetts, is expanded to cover more people. States were given the choice of rejecting the Medicaid expansion by the Supreme Court decision that upheld the ACA, and some states have elected not to accept the expanded coverage and the temporary federal funding that comes with it. Massachusetts elected to participate
Ms. Kuh said that as many as a third of Islanders covered now by Commonwealth Care may qualify for the expanded MassHealth program. “The big picture is that there is more assistance available for people up to a higher income level than with the state plan, and there are new plans for young adults,” she said. “The good news about the new federal law is that there are options for more people to get different types of assistance and coverage.”
Both the state and federal plans operate through exchanges where a variety of private insurance plans are offered to people who meet qualifying conditions. Ms. Kuh said the same companies providing insurance under the state plan are also providing similar plans under the ACA.
The new federal program can be accessed by anyone with a computer and an Internet connection. Applying for the state plans could only be done through state offices and approved organizations like VHCA and the Martha’s Vineyard Hospital.
Ms. Kuh said that VHCA will continue to assist anyone without computer access or those who find the whole process bewildering. Martha’s Vineyard Hospital (MVH) chief executive officer Tim Walsh said the hospital will continue to provide assistance as well.
Island medical service providers do not expect significant changes with the switch to the federal program.
“Massachusetts is so far ahead of the curve,” Cynthia Mitchell, director of Island Health Care, said in an interview with The Times. “It will be business as usual. There will be some changes behind the scenes, in who and how we bill, but we don’t expect our patient load to change as a result of the new law.”
Mr. Walsh agreed. “When the state plan went into effect in 2006, there were big changes in the numbers of patients who had been unable to pay who qualified for insurance coverage.” He said if anything the new Medicaid expansion will make things easier for the hospital.
“It is easier to bill MassHealth than the insurance companies,” he said.
Unlike many states that are using websites designed by the federal program to implement the ACA, Massachusetts has been using its own. The technical problems and delays associated with the federal sites have been largely absent from the Massachusetts site.
Ms. Kuh said that the state system is not perfect, and the state is regularly fine-tuning the site. She suggests waiting until the end of October or later to go online to check the options if earlier attempts are problematic.
Businesses employing 50 or more are required to provide medical insurance for their full-time employees under the ACA, or they face penalties. There are new minimum coverage requirements and reporting rules for businesses. Premium assistance will be available for companies with fewer than 50 employees depending on income and the type of coverage an employer provides.
Patient Protection and Affordable Care Act (ACA), known as Obamacare, is the new national health care law.
Commonwealth Care is the name of the Massachusetts state insurance exchange started in 2006 to provide affordable health insurance options. It is being phased out by the ACA and is now called MA Health Connector, or Connector.
MA Health Connector, or Connector is the new state exchange or marketplace for the federal ACA mandated insurance options. Its website is mahealthconnector.org. Phone number is 1-800-841-2900. The Connector’s open enrollment period began on October 1 and runs until March 31, 2014. There will be open enrollment periods in future years.
Connector Care is the new program that subsidizes premiums for qualified health plans for people who are income eligible, even those who have employer provided insurance.
Medicaid is a federally funded program that provides medical insurance for low income people and some with long care needs. Administered by individual states, it is called MassHealth in Massachusetts.
Medicare is a federal insurance program started in 1965, for people aged 65 and older and younger people with disabilities and some diseases. People covered by Medicare are unaffected by the new ACA.